U.S. patent application number 14/994536 was filed with the patent office on 2016-07-21 for electrosurgical instrument.
The applicant listed for this patent is GYRUS MEDICAL LIMITED. Invention is credited to Kelvin John VARNEY.
Application Number | 20160206367 14/994536 |
Document ID | / |
Family ID | 52630676 |
Filed Date | 2016-07-21 |
United States Patent
Application |
20160206367 |
Kind Code |
A1 |
VARNEY; Kelvin John |
July 21, 2016 |
ELECTROSURGICAL INSTRUMENT
Abstract
An electrosurgical instrument includes a pair of opposing first
and second jaw members (5), (6) movable from a first open position
in which the jaw members are disposed in a spaced relation relative
to one another, to a second closed position in which the jaw
members cooperate to grasp tissue therebetween. A first sealing
electrode (7) is located on the first jaw member, and a second
sealing electrode (8) is located on the second jaw member. A
stationary flexible cutting electrode (11) is located adjacent the
throat area constituted by the convergence of the first and second
jaw members when in their open position. The electrical connections
of the instrument are such that when the jaw members (5), (6) are
in their closed position with tissue grasped therebetween, the
instrument is capable of sealing the tissue by passing an
electrosurgical current into the tissue from the first and second
sealing electrodes (7), (8). When the jaw members (5), (6) are in
their open position the instrument is capable of cutting tissue by
moving the instrument in a forward direction such that tissue comes
into contact with the cutting electrode (11), an electrosurgical
current passing into the tissue from the cutting electrode.
Inventors: |
VARNEY; Kelvin John;
(Abergavenny, GB) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
GYRUS MEDICAL LIMITED |
Cardiff |
|
GB |
|
|
Family ID: |
52630676 |
Appl. No.: |
14/994536 |
Filed: |
January 13, 2016 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2018/144 20130101;
A61B 18/1445 20130101; A61B 2018/00601 20130101; A61B 2018/1452
20130101; A61B 2018/0063 20130101; A61B 2018/00178 20130101 |
International
Class: |
A61B 18/14 20060101
A61B018/14 |
Foreign Application Data
Date |
Code |
Application Number |
Jan 16, 2015 |
GB |
1500716.4 |
Claims
1. An electrosurgical instrument including a handle including an
actuating mechanism movable between a first position and a second
position, a pair of opposing first and second jaw members, movement
of the actuating mechanism from its first position to its second
position causing at least one of the jaw members to move relative
to the other from a first open position in which the jaw members
are disposed in a spaced relation relative to one another, to a
second closed position in which the jaw members cooperate to grasp
tissue therebetween, the first and second jaw members defining a
throat area at which the jaw members converge when in their open
position, a first sealing electrode located on the first jaw
member, a second sealing electrode located on the second jaw
member, a flexible cutting electrode located adjacent the throat
area and in fixed relationship thereto, and electrical connections
capable of connecting the instrument to a source of electrosurgical
current, such that when the jaw members are in their closed
position with tissue grasped therebetween, the instrument is
capable of sealing the tissue by passing an electrosurgical current
into the tissue from the first and second sealing electrodes, and
when the jaw members are in their open position the instrument is
capable of cutting tissue by moving the instrument in a forward
direction such that tissue comes into contact with the cutting
electrode, an electrosurgical current passing into the tissue from
the cutting electrode.
2. An electrosurgical instrument according to claim 1, wherein the
cutting electrode comprises a wire extending from the first jaw
member to the second jaw member.
3. An electrosurgical instrument according to claim 2, wherein the
wire is located on the longitudinal axis on the centre line of the
first and second jaw members.
4. An electrosurgical instrument according to claim 2, wherein the
cutting electrode comprises two wires extending from the first jaw
member to the second jaw member, one on the outer face of each of
the first and second jaw members.
5. An electrosurgical instrument according to claim 1, wherein the
handle includes first and second pivoting arms, a distal portion of
the first arm constituting the first jaw member and a distal
portion of the second arm constituting the second jaw member.
6. An electrosurgical instrument according to claim 1, wherein the
first sealing electrode is electrically insulated from the first
jaw member by a first insulating member, and the second sealing
electrode is electrically insulated from the second jaw member by a
second insulating member.
7. An electrosurgical instrument according to claim 1, wherein the
electrical connections include a first connection capable of
connecting one or both of the first and second sealing electrodes
to a source of electrosurgical current, and a second connection
capable of connecting one or both of the first and second arms to a
source of electrosurgical current.
8. An electrosurgical instrument according to claim 7, wherein the
arrangement is such that when the jaw members are in their closed
position with tissue grasped therebetween, the instrument is
capable of sealing the tissue by passing an electrosurgical current
between one or both of the first and second sealing electrodes and
a remote return electrode connected to the source, and when the jaw
members are in their open position the instrument is capable of
cutting tissue by moving the instrument in a forward direction such
that tissue comes into contact with the cutting electrode, an
electrosurgical current passing from the cutting electrode to the
remote return electrode.
9. An electrosurgical instrument according to claim 1, wherein the
electrical connections comprise first, second and third connections
capable of connecting the first sealing electrode, the second
sealing electrode and the cutting electrode respectively to a
source of electrosurgical current.
10. An electrosurgical instrument according to claim 9, wherein the
arrangement is such that when the jaw members are in their closed
position with tissue grasped therebetween, the instrument is
capable of sealing the tissue by passing an electrosurgical current
between the first and second sealing electrodes, and when the jaw
members are in their open position the instrument is capable of
cutting tissue by moving the instrument in a forward direction such
that tissue comes into contact with the cutting electrode, an
electrosurgical current passing between the cutting electrode and
one or both of the first and second sealing electrodes.
11. A method of cutting tissue comprising the steps of i) providing
an electrosurgical instrument including a handle including an
actuating mechanism movable between a first position and a second
position, a pair of opposing first and second jaw members, movement
of the actuating mechanism from its first position to its second
position causing at least one of the jaw members to move relative
to the other from a first open position in which the jaw members
are disposed in a spaced relation relative to one another, to a
second closed position in which the jaw members cooperate to grasp
tissue therebetween, the first and second jaw members defining a
throat area at which the jaw members converge when in their open
position, at least a first sealing electrode located on the first
jaw member, a flexible cutting electrode located adjacent the
throat area and in fixed relationship thereto, ii) maneuvering the
instrument such that the first and second jaw members are in their
open position with tissue to be cut located between the jaw
members, iii) supplying electrosurgical energy to the electrodes
such that an electrosurgical cutting voltage is provided between
the cutting electrode and the sealing electrode, and iv) moving the
instrument forwardly while maintaining the jaws in their open
position and with the cutting electrode remaining stationary
relative to the first and second jaw members so as to cut tissue
coming into contact with the cutting electrode.
Description
TECHNICAL FIELD
[0001] Embodiments of this invention relate to an electrosurgical
instrument for cutting tissue, and to a method for cutting tissue
using an electrosurgical instrument and an associated
electrosurgical generator. Such instruments are commonly used for
the treatment of tissue in surgical intervention, most commonly in
"keyhole" or minimally invasive surgery, but also in "open"
surgery.
BACKGROUND TO THE INVENTION AND PRIOR ART
[0002] It is known to provide an electrosurgical instrument in
which the cutting of tissue is effected by means of an elongate
electrosurgical electrode extending along the inner surface of one
of a pair of jaw elements. U.S. Pat. No. 6,174,309 & 7,204,835
are two examples of this kind of instrument. U.S. Pat. No.
7,204,835 provides an arrangement in which tissue may be cut by the
forward movement of a jawed instrument with the jaws held in an
open position, a so-called "running cut".
SUMMARY OF THE INVENTION
[0003] Embodiments of the present invention attempt to provide an
improvement to electrosurgical instruments such as those described
above.
[0004] Accordingly, an electrosurgical instrument is provided
including a handle including an actuating mechanism movable between
a first position and a second position, [0005] a pair of opposing
first and second jaw members, movement of the actuating mechanism
from its first position to its second position causing at least one
of the jaw members to move relative to the other from a first open
position in which the jaw members are disposed in a spaced relation
relative to one another, to a second closed position in which the
jaw members cooperate to grasp tissue therebetween, the first and
second jaw members defining a throat area at which the jaw members
converge when in their open position, [0006] a first sealing
electrode located on the first jaw member, [0007] a second sealing
electrode located on the second jaw member, [0008] a flexible
cutting electrode located adjacent the throat area and in fixed
relationship thereto, and [0009] electrical connections capable of
connecting the instrument to a source of electrosurgical current,
such that when the jaw members are in their closed position with
tissue grasped therebetween, the instrument is capable of sealing
the tissue by passing an electrosurgical current into the tissue
from the first and second sealing electrodes, and when the jaw
members are in their open position the instrument is capable of
cutting tissue by moving the instrument in a forward direction such
that tissue comes into contact with the cutting electrode, an
electrosurgical current passing into the tissue from the cutting
electrode.
[0010] The fixed cutting electrode located adjacent the throat area
is specifically designed for use in a "running cut", in which the
first and second jaw members are held partially open, and the
instrument is moved in a forward direction against tissue entering
the V-shaped gap between the first and second jaw members. With a
cutting RF waveform supplied to the cutting electrode, the tissue
is severed in a "running cut" in a manner similar to moving open
scissors forwardly through wrapping paper. Published US patent
application 2013/0006242 describes a forceps instrument with a
rigid bar as a blade electrode positioned between the jaws. In
contrast, embodiments of the present invention provide a stationary
yet flexible electrode adjacent the throat area of the
instrument.
[0011] The source of electrosurgical current is conveniently an
external electrosurgical generator, although it is conceivable that
the electrosurgical generator may be contained within the
instrument itself as a self-contained "cordless" instrument. In
either arrangement, the connections are capable of directing an
electrosurgical current to the relevant electrodes carried by the
instrument.
[0012] The flexible cutting electrode preferably comprises a wire
extending from the first jaw member to the second jaw member.
Typically, the wire is located on the longitudinal axis on the
centre line of the first and second jaw members. Alternatively, the
cutting electrode conceivably comprises two wires extending from
the first jaw member to the second jaw member, one on the outer
face of each of the first and second jaw members. By the term
"wire" or "wires" there is herein meant to include a flexible
elongate metallic strip of whatever cross-section, not just those
having a circular cross-section. Whichever arrangement is employed,
tissue comes into contact with the cutting electrode as the
instrument is advanced through tissue with the jaw members held
partially open, and the tissue is severed by the electrosurgical
current supplied to the cutting electrode.
[0013] The first and second jaw members are preferably pivotable
with respect to one another about a pivot mechanism, and the
cutting electrode is conveniently adjacent the pivot mechanism. The
handle conveniently includes first and second pivoting arms, a
distal portion of the first arm constituting the first jaw member
and a distal portion of the second arm constituting the second jaw
member. The first sealing electrode is preferably electrically
insulated from the first jaw member by a first insulating member,
and the second sealing electrode is preferably electrically
insulated from the second jaw member by a second insulating member.
The electrical connections preferably include a first connection
capable of connecting one or both of the first and second sealing
electrodes to the source of electrosurgical current, and a second
connection capable of connecting one or both of the first and
second arms to the source.
[0014] In one typical arrangement, the instrument operates as a
monopolar electrosurgical instrument. In this arrangement, when the
jaw members are in their closed position with tissue grasped
therebetween, the instrument is capable of sealing the tissue by
passing an electrosurgical current between one or both of the first
and second sealing electrodes and a remote return electrode
connected to the electrosurgical generator. When the jaw members
are in their open position, the instrument is capable of cutting
tissue by moving the instrument in a forward direction such that
tissue comes into contact with the cutting electrode, an
electrosurgical current passing from the cutting electrode to the
remote return electrode. In this arrangement, the remote electrode
acts as a return electrode for either the first and second sealing
electrodes or for the cutting electrode, whichever is in use.
Electrosurgical current passes through the patient from the
electrodes to the remote return electrode, which is typically
attached to the patient at a part of the body well away from the
part of the body where the electrosurgical instrument is being
used.
[0015] Alternatively, the instrument operates as a bipolar
electrosurgical instrument. In this arrangement, the electrical
connections comprise first, second and third connections capable of
connecting the first sealing electrode, the second sealing
electrode and the cutting electrode respectively to the source of
electrosurgical current. In this bipolar arrangement, when the jaw
members are in their closed position with tissue grasped
therebetween, the instrument is capable of sealing the tissue by
passing an electrosurgical current between the first and second
sealing electrodes. Similarly when the jaw members are in their
open position, the instrument is capable of cutting tissue by
moving the instrument in a forward direction such that tissue comes
into contact with the cutting electrode, an electrosurgical current
passing between the cutting electrode and one or both of the first
and second sealing electrodes. In this bipolar construction, when
the instrument is being used to seal tissue, one of the sealing
electrodes acts as the return electrode for the other sealing
electrode. Alternatively, when the instrument is being used to cut
tissue, one or both of the sealing electrodes act as the return
electrode for the cutting electrode. In this way, electrosurgical
current passes through the patient only at the surgical site,
between the electrodes present on the instrument itself.
[0016] Embodiments of the invention further reside in a method of
cutting tissue comprising the steps of
[0017] i) providing an electrosurgical instrument including [0018]
a handle including an actuating mechanism movable between a first
position and a second position, [0019] a pair of opposing first and
second jaw members, movement of the actuating mechanism from its
first position to its second position causing at least one of the
jaw members to move relative to the other from a first open
position in which the jaw members are disposed in a spaced relation
relative to one another, to a second closed position in which the
jaw members cooperate to grasp tissue therebetween, the first and
second jaw members defining a throat area at which the jaw members
converge when in their open position, [0020] at least a first
sealing electrode located on the first jaw member, [0021] a
flexible cutting electrode located adjacent the throat area
mechanism and in fixed relationship thereto,
[0022] ii) maneuvering the instrument such that the first and
second jaw members are in their open position with tissue to be cut
located between the jaw members,
[0023] iii) supplying electrosurgical energy to the electrodes such
that an electrosurgical cutting voltage is provided between the
cutting electrode and the sealing electrode, and
[0024] iv) moving the instrument forwardly while maintaining the
jaws in their open position and with the cutting electrode
remaining stationary relative to the first and second jaw members
so as to cut tissue coming into contact with the cutting
electrode.
BRIEF DESCRIPTION OF THE DRAWINGS
[0025] Embodiments of the invention will now be further described,
by way of example only, with reference to the accompanying
drawings, in which:
[0026] FIG. 1 is a schematic side view of an electrosurgical
instrument in accordance with an embodiment of the present
invention,
[0027] FIG. 2 is an enlarged perspective view of a part of the
electrosurgical instrument of FIG. 1,
[0028] FIG. 3 is a schematic side view of an electrosurgical system
including the instrument of FIG. 1,
[0029] FIG. 4 is a schematic side view of an alternative
electrosurgical system including the instrument of FIG. 1, and
[0030] FIG. 5 is an enlarged perspective view of a part of an
alternative embodiment of electrosurgical instrument in accordance
with the present invention.
DESCRIPTION OF THE EMBODIMENTS
[0031] Referring to FIG. 1, an electrosurgical forceps instrument
is shown generally at 1, and comprises a first arm 2 pivotably
connected to a second arm 3 at a pivot point 4. The area of the
first arm distal of the pivot point 4 constitutes a first jaw
member 5, while the area of the second arm distal of the pivot
point 4 constitutes a second jaw member 6. A first sealing
electrode 7 is attached to the first jaw member 5, while a second
sealing electrode 8 is attached to the second jaw member 6, in
opposite corresponding relationship to the sealing electrode 7. The
electrodes 7 & 8 are electrically insulated from the jaw
members on which they are mounted by insulating members 9 & 10.
An insulating sleeve 21 is provided on the arms 2 & 3 in the
area held by the user of the instrument in order to protect them
from any electrosurgical currents.
[0032] FIG. 2 shows the jaw members 5 & 6 in more detail. A
cutting electrode in the form of a wire 11 is provided in the area
adjacent the pivot point 4, the wire 11 being attached to and
running between the first and second jaw members 5 & 6. In use,
when the instrument 1 is required to seal tissue, the jaw members 5
& 6 are closed grasping tissue to be sealed between the first
and second sealing electrodes 7 & 8. The electrosurgical
coagulation of the tissue is preformed in a conventional manner,
either in a bipolar arrangement with current passing from one
sealing electrode to the other, or in a monopolar arrangement with
current passing from one or both sealing electrodes to a remote
return pad (not shown).
[0033] When the instrument 1 is required to cut tissue, the jaw
members 5 & 6 are held in an open configuration as shown in
FIGS. 1 & 2, and an electrosurgical cutting voltage is supplied
to the wire 11. The instrument is then moved forwardly so that
tissue comes into contact with the wire 11. As the tissue is cut by
the wire 11, the instrument continues to be moved forwardly,
continuing to cut tissue in a "running cut", akin to cutting
wrapping paper with an open pair of scissors.
[0034] FIG. 3 shows the instrument 1 being connected to an
electrosurgical generator 12 in a bipolar method of operation, the
generator 12 having first second and third output connections 13,
14 & 15. In this arrangement, the first sealing electrode 7 is
connected to the first output connection 13 of the generator by
means of lead 16. Similarly, the second sealing electrode 8 is
connected to the second output connection 14 of the generator by
means of lead 17. Finally, the cutting wire 11 is connected to the
third output connection 15 of the generator by means of lead 18.
When the sealing of tissue is required, the generator 12 supplies a
coagulating RF voltage between output connections 13 & 14, and
hence first and second sealing electrodes 7 & 8. Conversely,
when the cutting of tissue is required, the generator 12 supplies a
cutting RF voltage between output connection 15 and output
connections 13 & 14, and hence between the cutting wire 11 and
one or both of the sealing electrodes 7 & 8.
[0035] FIG. 4 shows the instrument 1 being connected to an
electrosurgical generator 12 in a monopolar method of operation,
the generator 12 once again having first second and third output
connections 13, 14 & 15. In this arrangement, both the first
and second sealing electrodes 7 & 8 are connected to the first
output connection 13 of the generator by means of lead 19. The
cutting wire 11 is connected to the second output connection 14 of
the generator by means of lead 20. Finally, a remote return pad 22
is connected to the third output connection 15 of the generator by
means of lead 23. When the sealing of tissue is required, the
generator 12 supplies a coagulating RF voltage between output
connections 13 & 15, and hence between the first and second
sealing electrodes 7 & 8 and the return pad 22. Conversely,
when the cutting of tissue is required, the generator 12 supplies a
cutting RF voltage between output connection 14 and output
connection 15, and hence between the cutting wire 11 and the return
pad 22. Whether in sealing mode or in cutting mode, current flows
from the instrument 1 to the return pad 22, which is attached to
the body of the patient at an area remote from the area where the
tissue is being treated.
[0036] FIG. 5 shows an alternative embodiment of instrument in
which the single central wire 11 is replaced with a pair of wires
24 & 25, one located on each side of the jaw members 5 & 6.
As before, the wires 24 & 25 run between the jaw members, in an
area proximal of the sealing electrodes 7 & 8. The operation of
the instrument of FIG. 5 is as previously described, with the wires
24 & 25 acting as cutting electrodes as the instrument 1 is
moved forwardly with the jaw members 5 & 6 maintained in an
open condition.
* * * * *